Ryan T Alderman, LMFT

Individual provider Active NPI Marriage & Family Therapist · Chicago, IL

NPI 1295013126 · NPPES record last updated May 13, 2024

Key facts

NPI
1295013126
Entity type
Individual (NPI type 1)
Primary specialty
Marriage & Family Therapist 106H00000X
License
166000973 (IL)
Practice address
10725 S Western Ave
Chicago, IL 60643-3217
Phone
(872) 248-9559
NPI assigned
Jul 26, 2011
Sex
Male
Sole proprietor
Yes

Medicare Care Compare profile

Specialty
Marriage and Family Therapist
Education
Northwestern University Feinberg Medical School, 2011
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

10725 S Western Ave
Chicago, IL 60643-3217
Phone (872) 248-9559

Medicare participation

Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20260202001220 IL Practitioner - Marriage and Family Therapist 3870071756 Practice locations: Chicago, IL

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
166000973ILMDMarriage & Family Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 166000973 IL Yes

Addresses

Primary practice location

10725 S Western Ave
Chicago, IL 60643-3217

Mailing address

10725 S Western Ave
Chicago, IL 60643-3217
Phone (872) 248-9559

Other providers in Chicago, IL

All providers in Chicago, IL · Marriage & Family Therapist in Illinois

Sources for this page

Verify at the official NPI Registry.